Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study.
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Nishikawa Yoshitaka, Horimatsu Takahiro, Oka Shiro, Yamada Takeshi, Mitsui Keigo, Yamamoto Hironori, Takahashi Keiichi, Shiomi Akio, Hotta Kinichi, Takeuchi Yoji, Kuwai Toshio, Ishida Fumio, Kudo Shin-Ei, Saito Shoichi, Ueno Masashi, Sunami Eiji, Yamano Tomoki, Itabashi Michio, Ohtsuka Kazuo, Kinugasa Yusuke, Matsumoto Takayuki, Sugai Tamotsu, Uraoka Toshio, Kurahara Koichi, Yamaguchi Shigeki, Kato Tomohiro, Okajima Masazumi, Kashida Hiroshi, Fujita Fumihiko, Ikematsu Hiroaki, Ito Masaaki, Esaki Motohiro, Kawai Masaya, Yao Takashi, Hamada Madoka, Koda Keiji, Fukai Yasumori, Komori Koji, Saitoh Yusuke, Kanemitsu Yukihide, Takamaru Hiroyuki, Yamada Kazutaka, Nozawa Hiroaki, Takayama Tetsuji, Togashi Kazutomo, Shinto Eiji, Torisu Takehiro, Toyoshima Akira, Ohmiya Naoki, Kato Takeshi, Otsuji Eigo, Nagata Shinji, Hashiguchi Yojiro, Sugihara Kenichi, Ajioka Yoichi, Tanaka Shinji
Аннотация
METHODS: This retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests.
RESULTS: Data from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively.
CONCLUSION: Patients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.